Journal
EPILEPSY & BEHAVIOR
Volume 64, Issue -, Pages 4-8Publisher
ACADEMIC PRESS INC ELSEVIER SCIENCE
DOI: 10.1016/j.yebeh.2016.08.032
Keywords
Differential diagnosis; Epilepsy; Psychogenic nonepileptic seizures; Electronic health records
Categories
Funding
- Department of Veterans Affairs, Veterans Health Administration (VHA)
- VISN 1 Career Development Award
- VHA Health Services Research and Development Service Center of Innovation award [CIN 12-118, 13-047]
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Management of psychogenic nonepileptic seizures (PNES) requires collaboration among and between health care professionals. Although criteria are established for diagnosis of PNES, miscommunication between neurologists, primary care providers, and mental health professionals may occur if the clinical impression is not clearly articulated. We extracted progress notes from the DepaiLment of Veterans Affairs (VA) electronic health record (EHR) nationally to study veterans who were evaluated for PNES. Of the 750 patients being worked up for PNES, the majority of patients did not meet criteria for PNES (64.6%). Of those who were thought to suffer from PNES, 147 (19.6%) met International League Against Epilepsy (ILAE) criteria for documented PNES, 14 (1.9%) for clinically established PNES, and 104 (13.9%) for probable or possible PNES. Neurologists tended to use ambiguous language, such as thought to be or suggestive of to describe their impressions of patients overall, even those with definitive PNES. Ambiguous language may lead to miscommunication across providers and inappropriate health care. Published by Elsevier Inc.
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